Action Points

When fathers are more involved in young children's care, the children are less likely to be obese, according to survey information from a nationally representative longitudinal cohort study.

Note that previous research has shown that fathers have increased the time they spend with their children by nearly threefold since 1965, but there has been little research on the influence of fathers on childhood obesity.

When fathers are more involved in young children's care, the kids are less likely to be obese, according to survey data from a longitudinal cohort study.

Children of dads who more frequently performed caregiving tasks, such as helping them to brush their teeth, get dressed, or go to bed, were 33% less likely to be obese at ages 2-4 (OR 0.67, 95% CI 0.52 to 0.88, P<0.05), reported Michelle Wong, a doctoral student at the Johns Hopkins School of Public Health in Baltimore, and colleagues.

Every one-category increase in the frequency fathers took their kids out for walks or play reduced their obesity risk by 30% (OR 0.70, 95% CI 0.5 to 0.97, P<0.05), Wong's group reported online in Obesity.

Previous research has shown that fathers have increased the time they spend with their children by nearly threefold since 1965. Despite this, there has been little research on the influence of fathers on childhood obesity; most research has focused on mothers, Wong and colleagues said.

"Although fathers are participating more in child caregiving, the effects of their increased involvement on childhood obesity have been understudied," the investigators wrote. "Using models that controlled for all observed and unobserved time-invariant confounders, we found evidence that increases in fathers' involvement in caregiving are associated with lower odds of early childhood obesity."

"Findings from this study suggest that children may benefit from additional involvement from the father," they added. "Efforts to increase fathers' involvement might include actively including fathers in parenting childhood obesity interventions, and child healthcare providers actively engaging with fathers during their child's healthcare visits. To date, parenting childhood obesity interventions primarily target mothers. Fathers have noted feeling neglected during visits with their child's pediatricians."

Wong and colleagues analyzed data on approximately 3,900 children from the Early Child Longitudinal Study-Birth Cohort (ECLS-B), a nationally representative cohort of more than 10,000 children born in 2001. The cohort was designed to collect information on home and family influences on child development during the first 6 years of life. The ECLS-B administered surveys to the children's primary caregiver (95% of whom were biological mothers), and a separate survey to resident fathers.

All children in the current study came from two-parent, heterosexual households. More than half the children (64%) and fathers (67%) were white. Approximately 15% of families lived below the federal poverty line. About half the fathers (56%) had more than a high school education. On average, mothers worked part-time while fathers worked full-time.

The fathers' survey asked how often, in the past month, they had prepared meals for their child; took their child outside for walks or play at the park or playground; looked after their child while the mother did other things; and performed physical childcare tasks such as helping children go to bed, brush their teeth, bathe, and get dressed. The survey also assessed the father's role in making decisions about their child's nutrition, healthcare, and discipline.

The study's primary outcome was child weight at ages 2 and 4. Other outcomes included children's obesity-related behaviors, such as how frequently they watched TV and consumed sugar-sweetened beverages. The investigators controlled for potential confounders such as the number of hours per week fathers and mothers worked and the family's poverty status.

Wong and colleagues reported non-significant trends toward reduced obesity risk associated with fathers more frequently preparing meals for children (OR 0.73, 95% CI 0.51 to 1.03, P<0.10) and looking after children while the mother did other things (OR 0.75, 95% CI 0.55 to 1.03, P<0.10). Similarly, a father's increasing role in making decisions about the child was associated with a trend toward reduced obesity risk (OR 0.56, 95% CI 0.29 to 1.09) and reduced sugar-sweetened beverage consumption (OR 0.74, 95% CI 0.52 to 1.06) (P-values were not reported).

The investigators noted several study limitations, including that fathers' self-reports about their roles in caregiving and decision-making were not independently verified. In addition, because the study was limited to two-parent heterosexual households, the results may not be generalizable to other types of families, they said.

"Future studies can utilize more precise information on both mothers' and fathers' caregiving involvement and influence, such as time-use data, to allow for more definitive estimates of these relationships and more detail on fathers' involvement (e.g., what they do when outside with their child). Information on maternal involvement can also help elucidate pathways through which fathers' involvement and influence might confer child weight benefits," Wong and colleagues concluded.

The study was funded by the Agency for Healthcare Research and Quality and the National Institute of Diabetes and Digestive and Kidney Diseases.

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